scholarly journals Autism Tsunami: the Impact of Rising Prevalence on the Societal Cost of Autism in the United States

2021 ◽  
Author(s):  
Mark Blaxill ◽  
Toby Rogers ◽  
Cynthia Nevison
Keyword(s):  
Forecast Model ◽  
The United States ◽  
Population Projections ◽  
Base Case ◽  
Prevention Strategies ◽  
Total Base ◽  
Cost Categories ◽  
The Cost ◽  
The Impact ◽  
First Time

AbstractThe cost of ASD in the U.S. is estimated using a forecast model that for the first time accounts for the true historical increase in ASD. Model inputs include ASD prevalence, census population projections, six cost categories, ten age brackets, inflation projections, and three future prevalence scenarios. Future ASD costs increase dramatically: total base-case costs of $223 (175–271) billion/year are estimated in 2020; $589 billion/year in 2030, $1.36 trillion/year in 2040, and $5.54 (4.29–6.78) trillion/year by 2060, with substantial potential savings through ASD prevention. Rising prevalence, the shift from child to adult-dominated costs, the transfer of costs from parents onto government, and the soaring total costs raise pressing policy questions and demand an urgent focus on prevention strategies.

scholarly journals Economic value of insertable cardiac monitors in unexplained syncope in the United States

Open Heart ◽  
2021 ◽  
Vol 8 (1) ◽  
pp. e001263
Author(s):  
Brad S Sutton ◽  
Sarah L Bermingham ◽  
Alexander Diamantopoulos ◽  
Sarah C Rosemas ◽  
Stelios I Tsintzos ◽  
...  
Keyword(s):  
Diagnostic Testing ◽  
Economic Value ◽  
Cost Savings ◽  
The United States ◽  
Base Case ◽  
Payer Perspective ◽  
Life Years ◽  
Unexplained Syncope ◽  
The Cost ◽  
The Impact

IntroductionEarly use of insertable cardiac monitor (ICM) is recommended for patients with unexplained syncope following initial clinical workup, due to its superior ability to establish symptom-rhythm correlation compared with conventional testing (CONV). However, ICMs incur higher upfront costs, and the impact of additional diagnoses and resulting treatment on downstream costs and outcomes is unclear. We aimed to evaluate the cost-effectiveness of ICM compared with CONV for the diagnosis of arrhythmia in patients with unexplained syncope, from a US payer perspective.MethodsA Markov model was developed to estimate lifetime costs and benefits of arrhythmia diagnosis with ICM versus CONV, considering all related diagnostic and arrhythmia-related treatment costs and consequences. Cohort characteristics and costs were informed by original claims database analyses. Risks of mortality, syncopal recurrence, injury due to syncope and quality of life consequences from syncopal events were identified from the literature.ResultsICM was less costly and more effective than CONV. Most of the observed US$4532 cost savings were attributed to reduced downstream diagnostic testing. For every 1000 patients, ICM was projected to yield an additional 253 arrhythmia diagnoses and lead to treatment in an additional 168 patients. The ICM strategy resulted in overall improved outcomes (0.30 quality-adjusted life years gained), due to a reduction in syncope recurrence and injury resulting from arrhythmia treatment. The results were robust to changes in the base case parameters but sensitive to the model time horizon, underlying probability of syncope recurrence and prevalence of arrhythmias.ConclusionsOur model projected that early ICM for the diagnosis of unexplained syncope reduced long-term costs, and led to an improvement in overall clinical outcomes by shortening time to arrhythmia treatment. The cost of ICM was outweighed by savings arising from fewer downstream diagnostic episodes, and the increased cost of treatment was counterbalanced by fewer syncope-related event costs.

Demonstrating Nutrient Cost Gradients: A Brooklyn Case Study

2014 ◽  
Vol 84 (5-6) ◽  
pp. 244-251 ◽  
Author(s):  
Robert J. Karp ◽  
Gary Wong ◽  
Marguerite Orsi
Keyword(s):  
Low Income ◽  
Energy Content ◽  
Food Selection ◽  
The United States ◽  
United States Department ◽  
Micronutrient Deficiencies ◽  
Caloric Density ◽  
Low Income Families ◽  
The Cost ◽  
The Impact

Abstract. Introduction: Foods dense in micronutrients are generally more expensive than those with higher energy content. These cost-differentials may put low-income families at risk of diminished micronutrient intake. Objectives: We sought to determine differences in the cost for iron, folate, and choline in foods available for purchase in a low-income community when assessed for energy content and serving size. Methods: Sixty-nine foods listed in the menu plans provided by the United States Department of Agriculture (USDA) for low-income families were considered, in 10 domains. The cost and micronutrient content for-energy and per-serving of these foods were determined for the three micronutrients. Exact Kruskal-Wallis tests were used for comparisons of energy costs; Spearman rho tests for comparisons of micronutrient content. Ninety families were interviewed in a pediatric clinic to assess the impact of food cost on food selection. Results: Significant differences between domains were shown for energy density with both cost-for-energy (p < 0.001) and cost-per-serving (p < 0.05) comparisons. All three micronutrient contents were significantly correlated with cost-for-energy (p < 0.01). Both iron and choline contents were significantly correlated with cost-per-serving (p < 0.05). Of the 90 families, 38 (42 %) worried about food costs; 40 (44 %) had chosen foods of high caloric density in response to that fear, and 29 of 40 families experiencing both worry and making such food selection. Conclusion: Adjustments to USDA meal plans using cost-for-energy analysis showed differentials for both energy and micronutrients. These differentials were reduced using cost-per-serving analysis, but were not eliminated. A substantial proportion of low-income families are vulnerable to micronutrient deficiencies.

scholarly journals 1719. Respiratory Syncytial Virus-Associated Hospitalization Rates among US Infants: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S843-S843
Author(s):  
John M McLaughlin ◽  
Farid L Khan ◽  
Heinz-Josef Schmitt ◽  
Yasmeen Agosti ◽  
Luis Jodar ◽  
...  
Keyword(s):  
Public Health ◽  
Respiratory Syncytial Virus ◽  
Active Surveillance ◽  
Meta Analysis ◽  
The United States ◽  
Administrative Claims ◽  
Prevention Strategies ◽  
Hospitalization Rates ◽  
Syncytial Virus ◽  
The Impact

Abstract Background Understanding the true magnitude of infant respiratory syncytial virus (RSV) burden is critical for determining the potential public-health benefit of RSV prevention strategies. Although global reviews of infant RSV burden exist, none have summarized data from the United States or evaluated how RSV burden estimates are influenced by variations in study design. Methods We performed a systematic literature review and meta-analysis of studies describing RSV-associated hospitalization rates among US infants. We also examined the impact of key study characteristics on these estimates. Results After review of 3058 articles through January 2020, we identified 25 studies with 31 unique estimates of RSV-associated hospitalization rates. Among US infants &lt; 1 year of age, annual rates ranged from 8.4 to 40.8 per 1000 with a pooled rate= 19.4 (95%CI= 17.9–20.9). Study type was associated with RSV hospitalization rates (P =.003), with active surveillance studies having pooled rates per 1000 (11.1; 95%CI: 9.8–12.3) that were half that of studies based on administrative claims (21.4; 95%CI: 19.5–23.3) or modeling approaches (23.2; 95%CI: 20.2–26.2). Conclusion Applying the pooled rates identified in our review to the 2020 US birth cohort suggests that 73,680 to 86,020 RSV-associated infant hospitalizations occur each year. To date, public-health officials have used conservative estimates from active surveillance as the basis for defining US infant RSV burden. The full range of RSV-associated hospitalization rates identified in our review better characterizes the true RSV burden in infants and can better inform future evaluations of RSV prevention strategies. Disclosures John M. McLaughlin, PhD, Pfizer (Employee, Shareholder) Farid L. Khan, MPH, Pfizer (Employee, Shareholder) Heinz-Josef Schmitt, MD, Pfizer (Employee, Shareholder) Yasmeen Agosti, MD, Pfizer (Employee, Shareholder) Luis Jodar, PhD, Pfizer (Employee, Shareholder) Eric Simões, MD, Pfizer (Consultant, Research Grant or Support) David L. Swerdlow, MD, Pfizer (Employee, Shareholder)

The Impact of Regional Differences in Prices and Wages on Economic Growth: The United States in 1890

1979 ◽  
Vol 39 (1) ◽  
pp. 69-85 ◽  
Author(s):  
Philip R. P. Coelho ◽  
James F. Shepherd
Keyword(s):  
United States ◽  
Well Being ◽  
The United States ◽  
City Size ◽  
Cost Of Living ◽  
Real Wages ◽  
Industrial Growth ◽  
Wage Earners ◽  
The Cost ◽  
The Impact

Differences in regional prices and wages are examined for the United States in 1890, together with the relationship between the cost of living and city size, and the determinants of regional industrial growth. Results indicate that regional cost-of-liying differences were sufficiently large so that money wages cannot be used for purposes of comparing the economic well-being of wage earners across regions. Except for the South, money wages and the cost of living were positively correlated. The relative differences in money wages, however, were greater; consequently real wages in high wage-price areas were generally higher.

Neuroscience20 (BRAIN20, SPINE20, and MENTAL20) Health Initiative: A Global Consortium Addressing the Human and Economic Burden of Brain, Spine, and Mental Disorders Through Neurotech Innovations and Policies

2021 ◽  
pp. 1-39
Author(s):  
Kevin Morris ◽  
Mohammad Nami ◽  
Joe F. Bolanos ◽  
Maria A. Lobo ◽  
Melody Sadri-Naini ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Neurological Disorders ◽  
World Economy ◽  
Disease Burden ◽  
The United States ◽  
Fast Tracking ◽  
The World ◽  
Life Threatening ◽  
The Cost ◽  
The Impact

Neurological disorders significantly impact the world’s economy due to their often chronic and life-threatening nature afflicting individuals which, in turn, creates a global disease burden. The Group of Twenty (G20) member nations, which represent the largest economies globally, should come together to formulate a plan on how to overcome this burden. The Neuroscience-20 (N20) initiative of the Society for Brain Mapping and Therapeutics (SBMT) is at the vanguard of this global collaboration to comprehensively raise awareness about brain, spine, and mental disorders worldwide. This paper aims to provide a comprehensive review of the various brain initiatives worldwide and highlight the need for cooperation and recommend ways to bring down costs associated with the discovery and treatment of neurological disorders. Our systematic search revealed that the cost of neurological and psychiatric disorders to the world economy by 2030 is roughly $16T. The cost to the economy of the United States is $1.5T annually and growing given the impact of COVID-19. We also discovered there is a shortfall of effective collaboration between nations and a lack of resources in developing countries. Current statistical analyses on the cost of neurological disorders to the world economy strongly suggest that there is a great need for investment in neurotechnology and innovation or fast-tracking therapeutics and diagnostics to curb these costs. During the current COVID-19 pandemic, SBMT, through this paper, intends to showcase the importance of worldwide collaborations to reduce the population’s economic and health burden, specifically regarding neurological/brain, spine, and mental disorders.

scholarly journals The demography of desert Australia

2008 ◽  
Vol 30 (1) ◽  
pp. 29 ◽  
Author(s):  
Dominic Brown ◽  
John Taylor ◽  
Martin Bell
Keyword(s):  
Economic Policy ◽  
Arid Zone ◽  
Policy Implications ◽  
Population Projections ◽  
Research Centre ◽  
Arid Zones ◽  
Demographic Information ◽  
The Impact ◽  
First Time ◽  
Semi Arid

In recent years, with the formation of organisations such as the Desert Knowledge Cooperative Research Centre, social science interest in the Australian desert has re-surfaced with a research emphasis that is focused on creating sustainable futures for the region. One consequence of this is a demand for detailed demographic information to allow an assessment of different quanta of need in social and economic policy, and for assessment of the impact of these in environmental policy. However, demographic analysis on human populations in the desert to date has attracted very little research attention. In this paper we begin to address this lack of analysis by focusing on the populations, both aboriginal and non-aboriginal, of the arid and semi-arid zones of Australia. We extend earlier analysis by including for the first time demographic information on the semi-arid as well as the arid zone to establish the spatial pattern of population growth within the whole desert area drawing attention to the resulting settlement structure as an outcome of prevailing social, cultural and economic conditions. By examining population structure and demographic components of population change we also present for the first time population projections for the semi-arid zone and, therefore, in combination with the arid zone, for the entire Australian desert. All of this provides a basis for considering social and economic policy implications and the nature of underlying processes that drive change in this region.

scholarly journals Venture financing in the era of increasing epidemiological risks

2021 ◽  
Vol 2021 (8) ◽  
pp. 68-80
Author(s):  
Mykhailo DYBA ◽  
◽  
Iuliia GERNEGO ◽  
Keyword(s):  
United States ◽  
The United States ◽  
Venture Capitalists ◽  
Financing Policies ◽  
Current Trends ◽  
Social And Economic Development ◽  
Venture Financing ◽  
Venture Funding ◽  
The Impact ◽  
First Time

The relevance of the study of venture financing development in the era of increasing epidemiological risks is considered within the current situation in society, namely the significant impact of COVID-19 on all sectors of social and economic development. This shows the urgency of a systematic justification of current trends and peculiarities of venture financing development, taking into consideration the COVID-19 situation. The above-mentioned aspects define the purpose of our study. The theoretical basis of our study means the analysis of the specifics and priorities of venture financing, considering the timeframe from venture financing formation to nowadays. Thus, the stages of evolution of views on venture financing are highlighted. The article examines the dynamics of venture financing globally, as well as the change of relevant indicators in Europe, Asia and the United States. In particular, along with the analysis of the total amount of venture financing in each of the considered markets, the volumes of venture financing agreements that were carried out for the first time were estimated. This allowed us to analyze the relevant trends and make conclusions on the priority objects for attracting the resources of venture investors in the era of growth of epidemiological risks, depending on the experience of venture capitalists. The article compares venture funding and the incidence of COVID-19 in some countries in Europe, Asia and the United States. The approaches of European experts to the assessment of the impact of COVID-19 on venture financing are revealed. The analysis of the relevant calculations provides the possibility to structure the priorities of modern venture investors depending on the sectoral distribution of COVID-19 influences. The practical value of the study is considered within a comprehensive analysis of trends in venture financing and assessment of changes in the priorities of venture investors, considering the increasing epidemiological risks. The research may be useful both in the context of developing public venture financing policies and within developing venture financing strategies at the business level.

Abstract 200: Cost-Effectiveness of Newer Anticoagulants for Stroke Prevention in Atrial Fibrillation

2013 ◽  
Vol 6 (suppl_1) ◽  
Author(s):  
Brendan L Limone ◽  
William L Baker ◽  
Craig I Coleman
Keyword(s):  
Atrial Fibrillation ◽  
Cost Effectiveness ◽  
Stroke Prevention ◽  
Indirect Comparison ◽  
Cost Effective ◽  
The United States ◽  
Base Case ◽  
Treatment Comparison ◽  
Newer Anticoagulants ◽  
The Cost

Background: A number of new anticoagulants for stroke prevention in atrial fibrillation (SPAF) have gained regulatory approval or are in late-stage development. We sought to conduct a systematic review of economic models of dabigatran, rivaroxaban and apixaban for SPAF. Methods: We searched the Medline, Embase, National Health Service Economic Evaluation Database and Health Technology Assessment database along with the Tuft’s Registry through October 10, 2012. Included models assessed the cost-effectiveness of dabigatran (150mg, 110mg, sequential), rivaroxaban or apixaban for SPAF using a Markov model or discrete event simulation and were published in English. Results: Eighteen models were identified. All models utilized a lone randomized trial (or an indirect comparison utilizing a single study for any given direct comparison), and these trials were clinically and methodologically heterogeneous. Dabigatran 150mg was assessed in 9 of models, dabigatran 110mg in 8, sequential dabigatran in 9, rivaroxaban in 4 and apixaban in 4. Adjusted-dose warfarin (either trial-like, real-world prescribing or genotype-dosed) was a potential first-line therapy in 94% of models. Models were conducted from the perspective of the United States (44%), European countries (39%) and Canada (17%). In base-case analyses, patients typically were at moderate-risk of ischemic stroke, initiated anticoagulation between 65 and 73 years of age, and were followed for or near a lifetime. All models reported cost/quality-adjusted life-year (QALY) gained, and while 22% of models reported using a societal perspective, no model included costs of lost productivity. Four models reported an incremental cost-effectiveness ratio (ICER) for a newer anticoagulant (dabigatran 110mg (n=4)/150mg (n=2); rivaroxaban (n=1)) vs. warfarin above commonly reported willingness-to-pay thresholds. ICERs (in 2012US$) vs. warfarin ranged from $3,547-$86,000 for dabigatran 150mg, $20,713-$150,000 for dabigatran 110mg, $4,084-$21,466 for sequentially-dosed dabigatran and $23,065-$57,470 for rivaroxaban. In addition, apixaban was demonstrated to be an economically dominant strategy compared to aspirin and to be dominant or cost-effective ($11,400-$25,059) vs. warfarin. Based on separate indirect treatment comparison meta-analyses, 3 models compared the cost-effectiveness of these new agents and reported conflicting results. Conclusions: Cost-effectiveness models of newer anticoagulants for SPAF have been extensively published. Models have frequently found newer anticoagulants to be cost-effective, but due to the lack of head-to-head trial comparisons and heterogeneity in clinical characteristic of underlying trials and modeling methods, it is currently unclear which of these newer agents is most cost-effective.

scholarly journals The Effects of a Web-Based Alcohol Prevention Program on Social Norms, Expectancies, and Intentions to Prevent Harm among College Student-Athletes

2016 ◽  
Vol 30 (2) ◽  
pp. 113-122 ◽  
Author(s):  
Melodie Fearnow-Kenney ◽  
David L. Wyrick ◽  
Jeffrey J. Milroy ◽  
Erin J. Reifsteck ◽  
Timothy Day ◽  
...  
Keyword(s):  
Alcohol Use ◽  
Social Norms ◽  
Prevention Program ◽  
Student Athletes ◽  
Alcohol Expectancies ◽  
The United States ◽  
Prevention Strategies ◽  
Effective Prevention ◽  
Harm Prevention ◽  
The Impact

College athletes are at risk for heavy alcohol use, which jeopardizes their general health, academic standing, and athletic performance. Effective prevention programming reduces these risks by targeting theory-based intermediate factors that predict alcohol use while tailoring content to student-athletes. The purpose of this study was to examine the impact of the myPlaybook online prevention program on student-athletes’ social norms, negative alcohol expectancies, and intentions to use alcohol-related harm prevention strategies. NCAA Division II student-athletes were recruited from 60 institutions across the United States to complete myPlaybook and pretest/posttest surveys measuring demographics and targeted outcome variables. Participants were randomly assigned to the treatment group (pretest-program-posttest; final n = 647) or the delayed treatment “control” group (pretest-posttest-program; final n = 709). Results revealed significant program effects on social norms (p < .01) and intentions to use harm prevention strategies (p < .01), while the effect on negative alcohol expectancies was nonsignificant (p = .14). Implications for future research and practice are discussed.

scholarly journals Extended Screening Costs Associated With Selecting Donors for Fecal Microbiota Transplantation for Treatment of Metabolic Syndrome-Associated Diseases

2017 ◽  
Vol 4 (4) ◽  
Author(s):  
Laura J Craven ◽  
Seema Nair Parvathy ◽  
Justin Tat-Ko ◽  
Jeremy P Burton ◽  
Michael S Silverman
Keyword(s):  
Metabolic Syndrome ◽  
Fecal Microbiota Transplantation ◽  
The United States ◽  
Fecal Microbiota ◽  
Screening Programs ◽  
Central Processing ◽  
Donor Screening ◽  
Increased Risk ◽  
The Cost ◽  
The Impact

Abstract Background Knowledge of the impact of the gut microbiome on conditions other than Clostridium difficile infection has been rapidly increasing, and the potential usefulness of fecal microbiota transplantation (FMT) in these indications is being explored. The need to exclude donors with an increased risk of these diseases has left uncertainties regarding the cost and feasibility of donor screening. The aim of this study was to compare our experience to other donor-screening programs and report the costs associated with establishing a donor-screening program, for the treatment of metabolic syndrome-related conditions. Methods Forty-six potential donors (PDs) had their medical histories and physical examinations undertaken by a physician. Blood, stool, and urine were screened for 31 viral, bacterial, fungal, and protozoan agents in addition to biochemical characteristics. The price of advertising, doctor’s visits and diagnostic tests were calculated to determine the cost of finding a donor. Results Of the PDs screened, 5 of 46 passed the history, examination, blood, stool, and urine tests. The most common reasons for exclusion included a body mass index &gt;25 or the detection of Blastocystis hominis, Dientamoeba fragilis, or Helicobacter pylori. Four of five eligible donors had subsequent travel or illness that contraindicated donation, so only 1 of 46 PDs was suitable. The total cost for finding a single suitable donor was $15190 US dollars. This screening was performed in Canada, and costs in the United States would be substantially higher. Conclusions New potential therapeutic uses for FMT have created a demand for stricter exclusion criteria for donors. This study illustrates that screening many individuals to find a donor and the subsequent associated costs may make central processing and shipment a more reasonable alternative.

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